E-drug: Re: Per capita allocation for medicines
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Dear Dr. Malavankar,
I can provide you with some figures from Mali, West-Africa. If you are
interested in more details, I can communicate to you by separate mail.
On the basis of:
a) routine data on drug revenues from drug cost-recovery systems in the
public sector, and
b) INRUD surveys on samples of prescriptions,
it appears that :
- the average cost (selling price to the public) per prescription (public
sector only!) is around US$ 1.5 (corresponding to US$ 0.75 to US$ 1.0 in
terms of FOB, as the selling price is 2.0 to 2.5 times FOB).
- the average cost (selling price to the public) of (essential) drugs
prescribed by the public sector PER CAPITA PER YEAR is about three times as
high, as the average utilisation of (public) health services in Mali is as
low as 0.3 (!) New Contacts (NC) per capita per year.
INRUD surveys show that over-prescription is still widespread (2.5 to 4
different drugs per prescription) and that the use of injections and
antibiotics is still too high. (No news for you, I assume...).
Self-medication is widespread in Mali, and many drugs, including
antibiotics and various injectables, are sold by private drug outlets with
and without prescription. Therefore, the total cost per capita per year of
all drugs (prescribed essential drugs plus non-prescribed essential and
brand-name drugs) is about two to three times higher than the above
estimate.
Ren� Dubbeldam, MD, MPH
ETC Crystal, Leusden, Holland
DubSlob@compuserve.com
NB. The enormous difference in utilisation of public health services in
Africa (extremely low in West-Africa; relatively high in East and Southern
Africa) is not easily explained and merits a comprehensive PhD thesis!
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